New Jersey officials have dedicated significant time, thought, and other resources in recent years to help combat the state’s epidemic of opioid addiction. And while the disease is still raging through communities around the state, those on the front lines say these efforts are starting to make a real difference in getting addicts into treatment.
But huge pitfalls remain in the path to sobriety, these experts added, speaking at a health committee hearing Thursday to examine how the state is doing in addressing opioid addiction.
And even successful programs need to be scaled up significantly to help scores of addicts and their families. Two problems are particularly troublesome: the fact that an addict who is arrested has a far better chance at getting into treatment than one who is not, and the serious shortage of treatment slots, both inpatient and out, in New Jersey.
“People are still turned away and some have even died waiting for treatment — and we can’t let that happen,” said Sen. Joseph Vitale, D-Middlesex, who chaired the hearing. “The lack of access to treatment for people is a crisis in itself.”
The hearing included testimony from a dozen witnesses with firsthand experience in treating opiate addiction, many of whom praised the bipartisan push in recent years from legislators and Gov. Chris Christie to prioritize substance abuse recovery. In his State of the State address last month, the governor pledged to expand this portfolio of programs. Firm numbers are hard to find, but Stephen Stirling, the lead reporter on NJ.com’s Herointown series, testified that there are at least 128,000 heroin addicts in the state and opioid addiction has killed more than 5,000 residents in the past decade.
The state is not alone in its focus on addiction. On Tuesday President Barack Obama announced his intention to include $1 billion in the next federal budget for heroin and other opioid treatment. U.S. Rep. Frank Pallone Jr (D-6th) introduced a plan last month to commit $500 million annually to training doctors and first responders to better spot and treat addiction, and to expand treatment options.
At least one of the efforts Christie announced last month is already making a difference. Connie Greene, vice president of the Barnabas Health Institute for Prevention, described a new effort in Ocean County that, after just 10 days, has shown a remarkable 70 percent success rate in getting hard-core addicts to agree to enter treatment.
The key is a “recovery specialist,” Greene said: a former addict with at least four years clean who can relate to a drug user in a way medical professionals can’t. Barnabas has hired 16 so far to work with addicts in Monmouth and Ocean counties who arrive at the hospital after receiving a shot of Narcan, a life-saving drug that can reverse an opioid overdose in minutes. These specialists meet addicts at the bedside within an hour of their arrival at the hospital and are there to help them connect with the treatment and other services they need in the weeks and months to come. The program is slated to expand to other counties with high rates of addiction, Greene said, including Passaic, Essex, and Camden.
“This program is going to change the face of addiction treatment in New Jersey,” Greene said, pointing out that without the help of these specialists, her program had failed over the past two years to convince any of the most troubled addicts to commit to treatment.
But the new effort’s success also highlights the need for more treatment programs, Greene added. The chronic shortage in New Jersey forced her to place several addicts signed up through the new specialists in treatment programs out of state. “The more work we do, the more we do getting them into treatment, the more desperate we are going to be without enough beds,” she said.
The program has also provided a huge benefit to the specialists themselves, most of who were struggling to find gainful employment, Sen. Robert Singer (R-Ocean) added. “This is a true program where the savings multiply, both for the addict and the recover coach,” he said. However, he said the state must request a federal waiver to make it easier for these specialists to access their patient’s private medical information in order to coordinate care with doctors and the other providers.
Several speakers expressed hope that the governor’s pledge to increase Medicaid reimbursement rates for doctors who provide addiction treatment will prompt more providers to get involved with the disease. But, with the supply of spots in both inpatient and outpatient programs severely limited, the few beds available tend to go addicts who are arrested or sentenced to treatment programs. There’s not enough room to help drug users before they get into trouble with the law, speakers said.
Sen. Ron Rice (D-Newark) pointed out that not all addicts who encounter law enforcement are lucky enough to get into treatment. “I can tell you, when people in Newark get arrested, they don’t get treatment,” he said.
The lack of treatment spots is an overarching problem, but there are other ways state lawmakers can make treatment more accessible and effective, speakers said. Lynda Bascelli, a primary care physician at a Camden clinic who recently completed addiction-treatment training, said it is critical that more family doctors learn to recognize the disease and obtain the medical tools to make a difference — like the right to dispense Suboxone, an effective replacement therapy for heroin, right from their office.
Marcelo Aguirre, a paramedic who works in Newark and Monmouth County, said he has seen how comprehensive training for EMTs can save lives — not just for admitted addicts, but also for elderly people or children who overdose by accident. But more education for medical providers can save more lives, he said.
Additional education for providers, greater regulation of treatment facilities, and a substance-abuse curriculum for students are other policies the state should consider, added Frank Greenagel, a substance-abuse counselor who runs two sober-living facilities at Rutgers University and heads the state’s opioid addiction task force. But the state’s efforts so far are a good first step, he said. “The numbers would be far worse if we didn’t have these programs.”